Evaluation of stereotactic radiosurgery in the treatment of trigeminal neuralgia

ABSTRACT

Introduction: Stereotactic radiosurgery used for treatment of TNN (Trigeminal Neuralgia) allows, using a gamma knife to direct a focused high radiation doze to the trigeminal nerve node and denaturize the nerve. [10] This procedure is relatively new and the long-term effects of it are not known, therefore, a number of technical issues related to the use of the opportunities and effectiveness of such an approach arise, which in scientific literature has not yet been fully elucidated.

Aim: The aim was to review the scientific literature and evaluate the stereotactic radiosurgery efficiency and applicability in trigeminal neuralgia treatment, focusing on the technical aspects of the method.

Materials and methods of work: A literature review conducted on the basis of “PubMed” 2006 to 2016 database, consisting of articles published in English language, which give an overview of clinical trials using radiofrequency surgical technique to treat trigeminal neuralgia. Search keywords were used in original language Search, use keywords in the original language: “radiosurgery”, “trigeminal neuralgia”, “gamma knife surgery” and “stereotactic radiosurgery”. Search criteria matched 12 publications, among them – 3 of meta-analysis.

Results and conclusions: The radiation dose role for the assessment of the gamma knife effectiveness is difficult to assess due to the fact that different studies used different tools to evaluate preoperative pain. Using the BNI (Barrow Neurological Institute) numerical and facial pain assessment scales before and after the radiofrequency surgical treatment, 62% of authors found that a greater pain reduction is observed when using a higher radiation dose (60-90 Gy). Reviewed research results show that the improved treatment efficiency and lower the likelihood of relapse shows when using stereotactic technology with higher exposure.

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